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Pseudoseptic arthritis: a case series and review of the literature

Brian P Oppermann1, Jonida K Cote, Stephanie J Morris

  • 1Department of Rheumatology, Geisinger Health System, 200 Scenery Drive, Danville, PA 16801, USA.

Case Reports in Infectious Diseases
|May 9, 2012
PubMed

Insights

Pseudoseptic arthritis, an acute inflammatory joint condition with sterile cultures, is rare but important. It should be considered in patients with existing inflammatory diseases presenting with sudden joint inflammation.

Area of Science:

  • Rheumatology
  • Immunology
  • Internal Medicine

Background:

  • Pseudoseptic arthritis is an acute inflammatory monoarthritis characterized by sterile synovial fluid.
  • This condition has been documented in patients with rheumatoid arthritis and microcrystalline disease.
  • Limited recent literature exists, with no reports since 1992.

Observation:

  • A 20-year retrospective chart review identified rheumatology inpatient consultations for pseudoseptic arthritis.
  • Ten cases were identified, with five detailed in this paper.
  • Most patients had pre-existing autoimmune or microcrystalline inflammatory arthritis.

Findings:

  • Pseudoseptic arthritis presents as acute monoarthritis in patients with chronic inflammatory conditions.
  • Synovial fluid analysis typically shows sterile Gram stain and culture.
  • The condition is a diagnostic consideration when septic arthritis is suspected but not confirmed bacteriologically.

Implications:

  • Highlights the need to include pseudoseptic arthritis in the differential diagnosis for acute monoarthritis.
  • Emphasizes the importance of considering this syndrome in patients with established inflammatory arthropathies.
  • Suggests a potential underdiagnosis or underreporting of this condition in rheumatology practice.

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